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AMERICAN RED CROSS NURSING SERVICE APPLICATION FOR ENROLLMENT (To be filled out entirely in applicant's handwriting) WEEK EMB I. Name of applicant Jane M. m Bourke 2. Address 1.2.8.0. pl. 3. Date of birth 2 June 1881 Place of birth Co. Kildare. Ireland 4. Are you married, single or a widow? single 5. Are you a citizen of the United States ? no 6. Have you any physical defects? no 7. Education and occupation before entering Training School in public & convent Educated School 8. From what Training School did you graduate? St. Louis Training school Teacher 9. Character of hospital: General? yes Special? Private? IO. beds in at time of graduation? sex hundred How many hospital II. Date of graduation 28. December 0.8 Length of course 3. years 12. Name and address of Superintendent of Training School under whom you were trained miss Warr 1224 Willon St- Ht Louis Mo I3. Of what nursing organization are you a member ? St- Louis aluminae 14. Give name and address of Secretary I5. Are you a registered nurse? yes In what State? Missouri Date of registration may 1910 16. How and where have you been employed since graduation? Give information for each year one. year City. Hospital - private nursing 17. Name and permanent address of nearest relative mary Bourke 1.28.a anhers. PL Signature Date May 2nd 11 Jane : m.Bourke Sh Louis Mo -

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49
Source index
0
Type
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Document data

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2661196
Core
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Type
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Document identity
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Document source extras
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    "naId": 2661196,
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Page context
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    "ocrText": "AMERICAN RED CROSS\nNURSING SERVICE\nAPPLICATION FOR ENROLLMENT\n(To be filled out entirely in applicant's handwriting)\nWEEK\nEMB\nI.\nName of applicant Jane M. m Bourke\n2. Address\n1.2.8.0. pl.\n3. Date of birth 2 June 1881\nPlace of birth Co. Kildare. Ireland\n4. Are you married, single or a widow? single\n5. Are you a citizen of the United States ? no\n6. Have you any physical defects?\nno\n7. Education and occupation before entering Training School in public & convent\nEducated\nSchool\n8. From what Training School did you graduate? St. Louis Training school\nTeacher\n9. Character of hospital: General? yes\nSpecial?\nPrivate?\nIO. beds in at time of graduation? sex hundred\nHow many hospital\nII. Date of graduation 28. December 0.8 Length of course 3. years\n12. Name and address of Superintendent of Training School under whom you were trained\nmiss Warr 1224 Willon St- Ht Louis Mo\nI3. Of what nursing organization are you a member ? St- Louis aluminae\n14. Give name and address of Secretary\nI5. Are you a registered nurse? yes In what State?\nMissouri\nDate of registration\nmay 1910\n16. How and where have you been employed since graduation? Give information for each year\none. year City. Hospital - private nursing\n17. Name and permanent address of nearest relative mary Bourke 1.28.a anhers. PL\nSignature\nDate May 2nd 11\nJane : m.Bourke Sh Louis\nMo\n-"
}